Sitat Opprinnelig skrevet av Vigdis Vis post
Har noen av dere erfaring med å øke dosen mye under sykdom?
Jeg tror, at det er ikke uden grund, at man får besked på at dobble dosen op. Vi er fortsat ret uvidende om, hvor meget (også sunde) binyrerne selv danner af mere cortisol ved de belastninger binyrerne ellers netop er indrettet til at kunne "dække". Så ved at udelade en effektiv doseøgning - sætter man sine binyrer i forlegenhed igen og dermed sætter hele støtteprocessen tilbage. Det kommer nok til at betyde, at efter at sygdommen er overstået - er man tilbage hvor man ellers var for måneder siden mht. binyrestatus.

Herunder hvad verdens, vist nok, største "hydrocortison-ekspert" anbefaler til patienter med binyre insufficiency ig i behandling med binyrestøtte ved hydrocortison. Jeg vil prøve at oversætte nedenstående så snart jeg kan, men indtil videre er det lige så nyttigt på engelsk:


INSTRUCTIONS FOR PATIENTS TAKING CORTISOL

Please read carefully and keep in a place they can be referred to frequently, such as a bulletin board or refrigerator door.

The medication that has been prescribed for you is a normal adrenal hormone. In the dosage that has been prescribed, it will not cause any of the harmful sideeffects that can result from an excessive dosage, but the instructions must be followed carefully. For this reason, the medication should be kept out of the reach of children or others who might take it by mistake. You will notice that the tablets taste somewhat bitter; so, like aspirin, if they are taken on an empty stomach they may cause gastric discomfort and indigestion. It is helpful, therefore, to take them just before meals or with milk or an antacid.

If you have ever had a peptic ulcer (of the stomach or duodenum), you should always take an antacid with each dose.

The medication is more effective if you spread out the day's dosage, so you should take __ tablet with each meal and at bedtime (or __ tablet with breakfast, __ tablet with lunch, __ tablet with supper, and __ tablet at bedtime), totaling __ tablets daily. It may be taken before, during, or after meals, but most patients prefer to take it just before meals. If a meal will be delayed over 2 hours or missed, try to take the medication at the usual mealtime.

If you forget to take a dose, for example at lunchtime, and remember it in the afternoon, take it when you think of it. If you do not remember it until the next dose is due, take both doses at the same time in order to have the correct total dosage for the day. It will not be harmful to double up on doses, but the medication will be more effective if you take each dose at the proper time. It is helpful to have a small pillbox in which each day's dosage is placed each morning and which is carried with you in your pocket or handbag at all times. This not only reminds you to take the medication, but also enables you to determine whether you have taken a dose. Sometimes it is difficult to remember whether you have taken a dose.

If you go on a vacation or trip, take at least two complete supplies of medication packed separately. Carry one with you and pack the other in your luggage. Then if one is lost, the other supply can replace it, because it might be difficult or expensive to replace medication when you are away from home. If you have mild or more severe adrenal deficiency, you should wear a Medic-Alert bracelet at all times in case you are in an accident and knocked unconscious, because doctors treating you need to know this in order to provide optimum treatment. If you do not have one, ask my secretary or me how to order one.

Because this is a normal hormone, it will not interfere with your taking any other medication. If you should develop symptoms of an incipient respiratory infection, such as a sore throat or nasal congestion, take a double dose of cortisol immediately and continue the double dosage until you have felt completely well for at least 24 hours, then return to your basic dosage. If symptoms last longer than a week, phone me. If you should develop symptoms of incipient influenza (chills, fever, malaise, aching), take 20 mg immediately and continue 20 mg four times daily until you contact me by phone. You should also take any other medication prescribed by me. If you develop "intestinal flu" (nausea, vomiting, diarrhea), take a double dosage of cortisol as soon as you can hold it down and phone me.

When these instructions are followed, infections usually clear more quickly, provided you do not smoke. If you smoke, you should stop smoking during any illness, as smoking will tend to delay your recovery and possibly cause complications. If any other questions arise, phone me.

Dr. William Mck. Jefferies

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